<form id="edit-form" class="form-horizontal" role="form" data-toggle="validator" method="POST" action="">
    {:token()}
    <input type="hidden" name="row[id]" value="{$row.id}">
    <div class="form-group">
        <label for="c-on_account" class="control-label col-xs-12 col-sm-2">{:__('赊账金额')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-on_account" readonly="readonly" class="form-control" name="row[on_account]" type="text" value="{$row.on_account|htmlentities}">
        </div>
    </div>

    <div class="form-group">
        <label for="c-supplementary" class="control-label col-xs-12 col-sm-2">{:__('补交金额')}:</label>
        <div class="col-xs-12 col-sm-8">
            <input id="c-supplementary" class="form-control" name="row[supplementary]" type="text" value="" data-tip="补交金额不能低于赊账金额">
        </div>
    </div>

    <div class="form-group">
        <label class="control-label col-xs-12 col-sm-2">{:__('支付方式')}:</label>
        <div id="pay" class="col-xs-12 col-sm-8">
            {:build_radios('row[pays]', ['1'=>__('转账'), '2'=>__('现金'),'3'=>__('pos机'),'4'=>__('支付宝'),'5'=>__('微信'),'6'=>__('储值卡'),'7'=>__('积分')])}
        </div>
    </div>


    <input type="hidden" name="row[id]" value="{$row.id|htmlentities}">
    <div class="form-group layer-footer">
        <label class="control-label col-xs-12 col-sm-2"></label>
        <div class="col-xs-12 col-sm-8">
            <button type="submit" class="btn btn-success btn-embossed disabled">{:__('OK')}</button>
            <button type="reset" class="btn btn-default btn-embossed">{:__('Reset')}</button>
        </div>
    </div>
</form>
